I'm an HIV positive man and I just began a relationship with a guy who is negative. He has been wonderful and accepting of me. I've been poz for over two years and am not currently on treatment. My latest few labs show my CD4 in the low normal range (400-500) with a viral load of 20-30 thousand. Going by the general trend in my labs I would estimate that it will probably be another one to maybe three years before I need to start ARV therapy anyway, but(in your opinion)is starting treatment early to reduce transmission risk worth the long term side effects? By the way, I have no drug resistance and achieved an undetectable viral load while on Kaletra/Truvada for 6-8 months following my early diagnosis. I would describe the side effects as manageable, mostly just a sensitive GI tract and very mild fatigue. Thanks for all your help!

Response from Dr. Frascino

Hi,

Is starting treatment early to reduce transmission risk worth the potential long-term side effects of antiretroviral drug therapy? Excellent question! Unfortunately I have a less than excellent answer. We honestly don't know! Certainly some magnetic couples have adopted this harm-reduction strategy. However, since most antiretrovirals currently in use are relatively new, we really don't have good long-term safety data yet. Also, even driving one's HIV plasma viral load to undetectable levels doesn't absolutely guarantee transmission won't occur. We know it significantly reduces the potential for HIV transmission, but it doesn't completely eliminate it. Consequently condoms are obviously still your first line of defense. So should you start therapy earlier or not? Only you can answer that question. Talk it over with your new Mr. Right and your HIV specialist. Ultimately you have the final say in this decision. I can tell you there is at least sound scientific reasoning for considering this option.

Good luck to both you and your new stud muffin. I'm wishing you a "happily-ever-after" life.

This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

The Body is a service of Remedy Health Media, LLC, 750 3rd Avenue, 6th Floor, New York, NY 10017. The Body and its logos are trademarks of Remedy Health Media, LLC, and its subsidiaries, which owns the copyright of The Body's homepage, topic pages, page designs and HTML code. General Disclaimer: The Body is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through The Body should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, consult your health care provider.